Correction of Flexural Deformity of the Metacarpophalangeal Joint in a Calf

Background: The congenital flexural deformity is common in cattle, often affecting the metacarpophalangeal joint of the thoracic limbs. The deformity may be mild, moderate, or severe, and the therapy depends on the limb's degree of flexion and the affected joint. In severe deformities, tenotomy of the flexor tendons and desmotomy of the suspensor ligament is recommended. However, this surgical technique may not be sufficient to promote limb extension, and other interventions may be necessary. Thus, the purpose of this report is to describe a technique to correct severe flexural deformities of the metacarpophalangeal joint in calves.Case: A three-month-old, female, Dutch-bred calf weighing 46 kg was referred for treatment of congenital flexural deformity. On attendance, the patient presented severe deformity in the right thoracic limb and mild in the left thoracic limb both at the height of the metacarpophalangeal joints. During palpation it was possible to notice that the flexor tendons were contracted in both limbs. Radiographic exams were performed to rule out the presence of other diseases, confirming the diagnosis of flexural deformity. The patient was referred to surgery to correct the anatomical anomaly. The animal was submitted to general anesthesia and placed in right lateral decubitus. In the left thoracic limb, an incision was made in the medial region of the metacarpal bone, the tissues were divulsioned until the superficial digital and deep digital flexor tendons were exposed; these structures were sectioned with a scalpel, and the limb was extended, returning to the standard anatomical position. In the right thoracic limb, the same procedure was performed, but during the limb extension test, we observed that the limb remained flexed, we then followed with a second incision and section of the deep digital flexor tendon in the palmar region at the middle phalanx of the lateral and medial digits, with this procedure, the limb extended further. Nevertheless, the procedure was not enough to solve the problem in the right thoracic limb, and the patient needed a second surgical intervention, in which we performed again tenotomy of the flexor tendons and desmotomy of the digital annular, crossed sesamoid, and interdigital phalangiosamoid ligaments, associated to the capsule opening of the capsule from the affected right metacarpophalangeal joint. After this surgery, the patient recovered to the normal anatomical position of the right thoracic limb. The procedures were efficient in achieving the normality of both affected limbs, and the patient recovered without postoperative complications.Discussion: In severe flexural deformities of the metacarpophalangeal joint in bovines, the fetlock's flexor tendons and suspensory ligament are implicated in the limb contracture. For these cases the chosen treatment is surgery with sequential sectioning of the flexor tendons and the suspensory ligament until the extension of the flexed limb occurs. Although there are reports that confirm the efficacy of this technique, there are cases in which other anatomic structures are involved in the limb contracture. In addition, the desmotomy and tenotomy techniques are not enough to achieve the normality of the affected joint, with the limb remaining flexed, leading to euthanasia of the patient in some cases. In cattle, few reports demonstrate possible techniques for severe contractures of the metacarpophalangeal joint, requiring further studies and new techniques to achieve recovery of these patients. Keywords: bovine, congenital, anatomical anomaly, contracture, tendon, fetlock.Descritores: bovinos, congênita, anomalia anatômica, contratura, tendão, boleto.Título: Correção de deformidade flexural da articulação metacarpofalangeana em  uma bezerr

INTOXICAÇÃO POR ORGANOFOSFORADO EM UM EQUINO: RELATO DE CASO

Os organofosforados são antiparasitários utilizados em animais domésticos, dentre os princípios ativos, encontra-se o triclorfon. Estes agentes têm ação anticolinesterásica, e podem causar intoxicação e óbito de forma aguda horas após sua administração. Estes fármacos geram hiperestimulação do sistema parassimpático, e os sinais clínicos manifestados são sialorreia, bradicardia, lacrimejamento, diarréia, fraqueza e tremores musculares (LOPES et al.,2014). Possuem alta toxicidade, existindo relatos de intoxicação por estes agentes na espécie humana e ruminantes, porém não há relatos em equinos.Um equino da raça Brasileiro de Hipismo, macho castrado, 5 anos, 447 kg, deu entrada no Hospital Veterinário com suspeita de intoxicação por organofosforado. O animal recebeu vermífugo oral a base de mebendazol e triclorfon, seguindo a dose recomendada, e horas após a ingestão do medicamento apresentou diarréia, dor abdominal moderada e apatia. Outros cavalos que receberam o antiparasitário demonstraram os mesmos sinais clínicos incluindo sialorréia, e grande parte destes animais vieram a óbito.Ao exame físico inicial o animal apresentou mucosa oral levemente ictérica, freqüência cardíaca (FC) de 36 bpm, freqüência respiratória (FR) 20mpm, temperatura retal de 37,8°C, tempo de preenchimento capilar (TPC) de 2,5 segundos, e hipomotilidade intestinal nos quadrantes superior e inferior direito; exibiu hiporexia, dor abdominal leve a moderada, e apatia. Durante o internamento a motilidade intestinal inicialmente ficou diminuída, tendo episódios de hipermotilidade e cólica. Nos picos de dor o animal apresentava FC acima de 40 bpm, fezes diarréicas, refluxo e febre, com pico de 38,9°C. A mucosa se tornou congesta, o animal apresentou miose, desidratação moderada e sialorréia, havendo melhora gradual com o tratamento.O animal foi submetido à terapia de suporte intensiva, sendo administrado flunixim meglumine 1,1mg/kg/24h, endovenoso (EV) para alívio da dor abdominal por 3 dias; metronidazol EV na dose de 15mg/kg e oral na dose de 25mg/kg  por 11 dias e transfaunação a cada 12 horas por 3 dias para resolução da diarreia; gentamicina 6,6mg/kg/24h EV; metoclopramida intramuscular (IM) a cada 4h como procinético usando dose de 10mg para cada 70kg de peso por dois dias; ranitidina endovenosa 1mg/kg/8h por seis dias, omeprazol oral 4m/kg/24h por 21 dias e sucralfato 20mg/kg/12h por cinco dias para tratamento de gastrite possivelmente causada pela hiporexia, estresse pela condição enferma, e pelo tratamento clínico. Para reversão da ação anticolinesterásica e melhora dos sinais clínicos, foi administrado atropina na dose de 0,017mg/kg, sendo aplicado 5ml EV e 10ml subcutâneo (SC) uma vez ao dia por dois dias. As soluções de glicose 5% e ringer com lactato foram escolhidas para fluidoterapia, neste caso, a solução glicosada foi utilizada devido a hiporexia e ao fato de a glicose ser necessária para eliminação de tóxicos pela via hepática.Com a terapia o animal teve recuperação gradativa, recebendo alta após 11 dias de internamento, voltando a atividade física após um mês de repouso, com bom desempenho. Neste caso o tratamento instituído foi capaz de gerar melhora e recuperação clínica total do animal, que posteriormente pôde voltar a suas atividades atléticas

Correction of Flexural Deformity of the Metacarpophalangeal Joint in a Calf

Background: The congenital flexural deformity is common in cattle, often affecting the metacarpophalangeal joint of the thoracic limbs. The deformity may be mild, moderate, or severe, and the therapy depends on the limb's degree of flexion and the affected joint. In severe deformities, tenotomy of the flexor tendons and desmotomy of the suspensor ligament is recommended. However, this surgical technique may not be sufficient to promote limb extension, and other interventions may be necessary. Thus, the purpose of this report is to describe a technique to correct severe flexural deformities of the metacarpophalangeal joint in calves.Case: A three-month-old, female, Dutch-bred calf weighing 46 kg was referred for treatment of congenital flexural deformity. On attendance, the patient presented severe deformity in the right thoracic limb and mild in the left thoracic limb both at the height of the metacarpophalangeal joints. During palpation it was possible to notice that the flexor tendons were contracted in both limbs. Radiographic exams were performed to rule out the presence of other diseases, confirming the diagnosis of flexural deformity. The patient was referred to surgery to correct the anatomical anomaly. The animal was submitted to general anesthesia and placed in right lateral decubitus. In the left thoracic limb, an incision was made in the medial region of the metacarpal bone, the tissues were divulsioned until the superficial digital and deep digital flexor tendons were exposed; these structures were sectioned with a scalpel, and the limb was extended, returning to the standard anatomical position. In the right thoracic limb, the same procedure was performed, but during the limb extension test, we observed that the limb remained flexed, we then followed with a second incision and section of the deep digital flexor tendon in the palmar region at the middle phalanx of the lateral and medial digits, with this procedure, the limb extended further. Nevertheless, the procedure was not enough to solve the problem in the right thoracic limb, and the patient needed a second surgical intervention, in which we performed again tenotomy of the flexor tendons and desmotomy of the digital annular, crossed sesamoid, and interdigital phalangiosamoid ligaments, associated to the capsule opening of the capsule from the affected right metacarpophalangeal joint. After this surgery, the patient recovered to the normal anatomical position of the right thoracic limb. The procedures were efficient in achieving the normality of both affected limbs, and the patient recovered without postoperative complications.Discussion: In severe flexural deformities of the metacarpophalangeal joint in bovines, the fetlock's flexor tendons and suspensory ligament are implicated in the limb contracture. For these cases the chosen treatment is surgery with sequential sectioning of the flexor tendons and the suspensory ligament until the extension of the flexed limb occurs. Although there are reports that confirm the efficacy of this technique, there are cases in which other anatomic structures are involved in the limb contracture. In addition, the desmotomy and tenotomy techniques are not enough to achieve the normality of the affected joint, with the limb remaining flexed, leading to euthanasia of the patient in some cases. In cattle, few reports demonstrate possible techniques for severe contractures of the metacarpophalangeal joint, requiring further studies and new techniques to achieve recovery of these patients. Keywords: bovine, congenital, anatomical anomaly, contracture, tendon, fetlock.Descritores: bovinos, congênita, anomalia anatômica, contratura, tendão, boleto.Título: Correção de deformidade flexural da articulação metacarpofalangeana em  uma bezerr